Endotoxin and cytokine removal in sepsis

Ciro Tetta, Rinaldo Bellomo, Paola Inguaggiato, Mary Lou Wratten, Claudio Ronco

Research output: Contribution to journalArticleResearchpeer-review

40 Citations (Scopus)

Abstract

Sespis, the leading cause of mortality in intensive care units, is a complex series of interrelated effects caused by the overproduction of multiple mediators and their unrestrained biological activity. Both proinflammatory and antiinflammatory mediators participate in the high complexity of sepsis and explain the failure of specific therapies to improve survival. Continuous extracorporeal therapies have been proposed as therapeutic options and as tools for blood purification in sepsis. Along these lines and in order to achieve higher clearances and mass removal rates, we studied the effects of plasmafiltration coupled with adsorption and provided in vitro and in vivo evidence that adsoprtion of multiple cytokines, activated complement components, and lipid mediators such as the platelet-activating factor occurs. We also showed that such treatment may lead to improved survival in a rabbit model of sepsis and to improved hemodynamics, reduced norepinephrine dose, and restoration of near-to-normal responsiveness of blood leukocytes to endotoxin in humans. It is anticipated that treatment of plasma, as a modular device to conventional hemofiltration, may pave the way to innovative approaches in the extracorporeal treatment of septic patients.

Original languageEnglish
Pages (from-to)109-115
Number of pages7
JournalTherapeutic Apheresis
Volume6
Issue number2
DOIs
Publication statusPublished - 23 May 2002
Externally publishedYes

Keywords

  • Cytokines
  • Endotoxin
  • Hemofiltration
  • Lipopolysaccharide
  • Plasmapheresis
  • Sepsis

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